Medical Assistance for Employed Persons with Disabilities (MA-EPD)

Medical Assistance for Employed Persons with Disabilities is a work incentive that promotes competitive employment and the economic self-sufficiency of people with disabilities by assuring continued access to Medical Assistance for necessary health care services.

MA-EPD allows working people with disabilities to qualify for MA under higher income and asset limits than standard MA. The goal of the program is to encourage people with disabilities to work and enjoy the benefits of being employed.
MA-EPD statistical information

Background

In the early 1990s, local disability advocacy groups publicized the need to allow workers with disabilities to retain their MA eligibility. The 1995 Minnesota Legislature authorized the Department of Human Services to seek a waiver from the federal government that would establish an earned income benefit for employed people with disabilities eligible for Social Security Disability Insurance and receiving personal care services under MA.

In 1998, the Minnesota Legislature asked Congress to remove Medicaid policy barriers to the employment of people with disabilities and in May 1999, the Minnesota Legislature approved MA-EPD. MA-EPD was implemented on July 1, 1999. Enrollment in the program grew rapidly and exceeded expectations.

Eligibility

To be eligible for MA-EPD a person must:

 Be certified disabled by either the Social Security Administration or the State Medical Review Team

 Be employed and have required taxes withheld or paid from earned income

 Have monthly earnings of more than $65

 Not be eligible for Medical Assistance under other, more beneficial categories

 Meet the asset limit (see below)

 Pay a premium (see below)

 Pay an "unearned income obligation" if required (see below)

What is the MA-EPD asset limit?

The asset limit for MA-EPD is $20,000. Some assets that do not count towards the limit are:

 Spouses assets

 Homestead property

 One motor vehicle under certain conditions

 Household goods, clothing and personal items

 Retirement accounts

 Medical expense accounts set up through an employer

 Burial space items or burial fund (up to $1,500)

What is the MA-EPD premium and unearned income obligation?

Note

Implementation of the MA-EPD premium and unearned income obligation increase, scheduled to take place Jan. 1, 2014, will be delayed. More information will be made available when known.

Premiums

Most people will have to pay a monthly premium to be on MA-EPD. MA-EPD premiums are based on a sliding fee scale or a minimum of $35, whichever is greater. Income and household size are used to calculate the premium. American Indian enrollees are not required to pay a premium. There is no maximum income limit or maximum premium amount for MA-EPD.

Unearned income obligation

In addition to the monthly MA-EPD premium, people who have unearned income, such as Social Security Disability, must pay one-half of one percent (1/2%) of their unearned income. To calculate the monthly-unearned income obligation, multiply the total unearned income amount by .005.

Minnesota has developed an online web tool that estimates a consumer's monthly premium. By entering information on earnings and household size, an estimated premium is calculated. For an estimate premium cost, click MA-EPD monthly premium estimator. For an actual, accurate premium, please contact your county human services agency.

What if a person loses their job or cannot work because of a medical condition?

Job loss

People on MA-EPD who lose their job through no fault of their own (they did not quit or are fired) may stay on MA-EPD for up to four months while looking for another job. If they do not have a job at the end of four months, they cannot be on MA-EPD.

Medical leave

People on MA-EPD who become unable to work because of a medical condition may stay on MA-EPD for up to four months. They must have a written, signed doctor's statement that says they are expected to return to work within four months. If they cannot return to work within four months, they cannot be on MA-EPD.

What services does MA-EPD cover?

MA-EPD pays for the same services as regular Medical Assistance, including:

 Home care services

 Inpatient hospital services

 Medical equipment services

 Mental health services

 Personal assistance services

 Physical, occupational and speech therapy

 Physician and health clinic visits

 Prescription drugs (Except enrollees who also have Medicare)

There are co-pays for some services, such as prescription drugs, non-preventive care visits and eyeglasses. See health care coverage.

In certain circumstances, Medicare or other health insurance premiums, co-pays and deductibles may be covered under MA-EPD.

Can a person be on MA-EPD and have other insurance?

Yes, people may have private, group or employer subsidized health insurance in addition to MA-EPD. Many services that are not covered by commercial insurance policies may be paid for by MA-EPD. If a person has other health insurance, that insurance must be used first, following the rules of that primary plan (e.g., must use network providers, obtain referral or authorization as required, etc.). Then services not covered may be paid through MA-EPD.

How can someone apply for MA-EPD?

How does working affect other benefits?

For information on how working may affect other benefits, such as Social Security Disability Insurance, Medicare, Social Security Income, Minnesota Supplemental Aid, private disability insurance, subsidized housing, food stamps and Veteran Benefits, go to Disability Benefits 101.